For people with end-stage kidney failure, Social Security may be available. Individuals may qualify for automatic approval of these benefits if they have been formally diagnosed with end-stage, including those waiting for a kidney transplant and those requiring dialysis. All individuals must meet the requirements listed under Genitourinary disorders from the Social Security Administration, listed in the Blue Book of qualifying medical conditions. These qualifications can be hard to understand, though.
What Is Considered End Stage?
People diagnosed with end-stage kidney failure typically have advanced conditions that make it impossible or nearly impossible for the kidneys to work properly. They require dialysis on a near-constant basis to filter toxins out of the blood because their kidneys no longer function properly. To be classified as end-stage, there is no likelihood that the kidneys will recover. This also means that a person may or may not be waiting for a kidney transplant.
If a person is facing this type of formal diagnosis, he or she can apply for compassionate care through the SSA. This will speed up the qualification process of securing benefits. With proper documentation and diagnosis from a doctor, this is an automatic approval process.
What Other Kidney Qualifications Does SSA Approve for Disability?
Other types of kidney disease may help people qualify for disability benefits. In these situations, the doctors must provide information that proves a person is unable to work due to their health condition. Nephritic syndrome is one example of a chronic kidney disease that falls into this category. In some cases, it may be approved immediately or, in others, individuals must meet specific criteria. For example, a person with this type of chronic kidney disease must have had medical documentation of it that lasts at least three months and creates severe symptoms such as severe edema, very high protein levels in urine, and decreased serum albumin levels in the blood.
Do Other Complications of Kidney Disease Qualify for Compensation?
Sometimes a person develops kidney failure or other types of kidney impairment suddenly. For example, they may have a hypertensive crisis, suffer a stroke, suffer congestive heart failure, physical trauma to the kidneys, or acute kidney failure for unknown reasons. In these situations, a person needs to meet SSA Blue Book criteria to receive kidney failure disability coverage. Most of the time, this will mean being in the hospital at least three times for these complications – whether or not they relate to other illnesses – in a single year. For those who have not met this requirement, benefits are not available just yet.
How Does a Person Prove These Medical Conditions Exist?
To receive kidney failure disability, an applicant must provide valid documentation of any illness, hospital stay, and testing to backup their condition. All medical records of treatments, lab results, dialysis, and other documentation showing the condition’s severity should be submitted to the SSA. Anything that shows residential functional capacity, periorbital, pretibial, and presacral edema, severe nephrotic syndrome, or other kidney-related symptoms, should be provided.
For those applying for immediate aid due to end-stage or chronic kidney disease, it is essential to provide all documentation during that first submission to ensure it is processed quickly.
Also note that, in some cases, doctors will perform a biopsy of the kidney tissues. This is a type of medical evidence that Social Security will use as well. Submit those results as well as any doctor’s statement that describes the findings of such biopsies.
What If a Person Has Multiple Conditions?
It is not uncommon for those who have kidney failure to have multiple other health complications. To receive kidney failure disability, a person needs to qualify under the SSA’s Blue Book of criteria completely for at least one of the conditions they have. A person with these conditions may qualify for SSA benefits:
- Fluid overload syndrome
- Anorexia and weight loss with a body mass index of 18 or lower when determined at least 90 days apart during a 12-month period
- Renal osteodystrophy, a type of bone disease that occurs as a result of the kidneys failing
- Peripheral neuropathy, a condition that causes severe numbness, pain, muscle weakness, in various areas of the body due to kidney failure
- End-stage congestive heart failure, a condition in which the heart does not pump properly, causing a failure of oxygen to reach the kidneys.
Individuals do not need to meet every one of these qualifications to qualify. However, a residual functional capacity exam, which is a questionnaire that determines a person’s ability to function, will be used to determine if he or she can work. This test looks at factors such as the ability to lift, sit, stand, and perform tasks.
If You Get a Kidney Transplant, Do You Still Qualify for Disability Benefits?
The answer here depends on multiple factors. While a transplant may seem to cure many of the failures a person has, it also presents its own set of complications. Every person’s needs are different here. Kidney transplants can expect to receive disability benefits for a full year after they receive the procedure. Once this initial year is up, a person must then prove to the SSA that they need to continue to access benefits due to an inability to work. This may, for example, due to complications from the surgery, rejection of the kidney, low residual functional capacity, and renal infections. Some people may also continue to qualify if they have moderate to severe side effects from the immunosuppressant medications prescribed.
At that one year point, individuals will need to work with their doctor to submit documentation to back up any claims made. The SSA will then review this information and determine if a person should still receive benefits based on their new and existing complications.
In all of these instances, a person should apply for kidney failure disability with as much detail as possible. Documenting end-stage or chronic kidney disease with a doctor’s support can help ensure a person meets the necessary criteria. Contact the Law Office of Daniel Berger today to get help to apply for these benefits.